In a decision that is sure to mystify Scott Walker, the Supreme Court decided not to review North Carolina’s Treat Women As If They Are Children Law (I fucking refuse to call it by its actual title, “A Women’s Right to Know Act,” because seriously?) on Monday,, rendering the condescending law unconstitutional in a rare bit of good news in the fight for women’s bodily autonomy. The North Carolina law was a “forced ultrasound” law that required women seeking to terminate their pregnancy to undergo an ultrasound*, regardless of medical necessity, and, while lying on the exam table half naked, have the doctor first describe the image to her, and then read her a prepared statement designed to convince her not to have an abortion. The little lady could close her eyes and plug up her ears if she so desired, but the doctor would have to complete his script or risk losing his license to practice.

It was a particularly draconian bit of compelled speech forced on patients in a particularly vulnerable position (half naked on an exam table, hours before a medical procedure), which is why it was blocked last year by a panel of judges on the Fourth Circuit. That court’s ruling gives some useful context for the severity of the law as it compares to other informed consent laws, so it’s worth including here:

Informed consent frequently consists of a fully-clothed conversation between the patient and physician, often in the physician’s office. It is driven by the “patient’s particular needs and circumstances” … so that the patient receives the information he or she wants in a setting that promotes an informed and thoughtful choice. This provision, however, finds the patient half-naked or disrobed on her back on an examination table, with an ultrasound probe either on her belly or inserted into her vagina… Informed consent has not generally been thought to require a patient to view images from his or her own body much less in a setting in which personal judgment may be altered or impaired. Yet this provision requires that she do so or “avert her eyes.”

Rather than engaging in a conversation calculated to inform, the physician must continue talking regardless of whether the patient is listening… The information is provided irrespective of the needs or wants of the patient, in direct contravention of medical ethics and the principle of patient autonomy. Forcing this experience on a patient over her objections in this manner interferes with the decision of a patient not to receive information that could make an indescribably difficult decision even more traumatic and could “actually cause harm to the patient.” … And it is intended to convey not the risks and benefits of the medical procedure to the patient’s own health, but rather the full weight of the state’s moral condemnation.

Forced ultrasound laws are just another arrow in the anti-choicer’s quiver of laws designed to sound perfectly reasonable and in the best interest of the women in question while attempting to hide there true purpose, which of course is the piecemeal elimination of abortion services. Based on public opinion and this ruling, it seems as if requiring an invasive medical procedure no matter the opinion of the women’s doctor is a bit of an overreach with this tactic, although what the ruling means for the 10 other states with forced ultrasound laws is a bit of an unknown until they each work their ways through the courts. Sadly it seems like a rare overreach, with many similar “the state knows what’s best for those flighty women folk” laws filling up state law books. Hospital admitting privileges, ambulatory surgical center requirements, and waiting periods all seem like good ideas on the surface and seem as if the health and safety of women are the priorities of the laws rather than making it more and more difficult for lower income women to access abortion services, until you scratch a bit and see a little deeper. Admitting privileges? Abortion very rarely has complications, and in the rare case of one the providers lack of admitting privileges is not going to lead to the woman dying in the street, refused care at the hospital. Of course, with the large number of hospitals affiliated with the Catholic Church and the simple fact that many secular hospitals don’t want to deal with the protesters and controversy that granting admitting privileges to a provider would invariably bring turns this seemingly well-intentioned regulation into a nifty way to eliminate abortion access. Waiting periods are condescending, but what harm can be caused by insisting on a day or two waiting period to think about such an important choice?** It seems like a minor inconvenience, and I am sure it is for the upper class women seeking abortion services. For the poorer woman who has to take multiple days off work, possibly arrange childcare on multiple days, and somehow procure transportation, quite a distance away in many cases, not once but now twice, the minor condescending inconvenience becomes a sometimes insurmountable hurdle. The ambulatory surgical center law is quite similar. After all, the lawmakers only want the women to receive their abortion in modern medical centers that are prepared to handle any possible emergency. What do us pro-choice people want anyway? A dirty table in a strip mall with a dumpster out back filled with fetuses? Of course, requiring a surgical center for a procedure that for many women can be accurately described as “taking a pill at home” seems a bit….., over concerned for the woman’s health? Which of course, is the point. The anti-choice right doesn’t give two shits about the health of the woman as long as she is forced to carry her pregnancy to term. Luckily, once you examine laws such as these their true purpose becomes clear as crystal, and the courts will definitely strike them down, right?

The Fifth Circuit Court of Appeals on Tuesday upheld nearly all of the provisions of HB 2, Texas’ extreme antiabortion law that requires abortion clinics to meet the hospital-like standards of ambulatory surgical centers, and mandates that abortion providers receive admitting privileges from nearby hospitals. The decision is expected to shutter all but a handful of abortion clinics across the state.

Sorry poor women. You just aren’t as equal as your rich sisters.

Apologies for crushing the good news under the bad. *shrug* That’s just the state of reproductive health at the moment.

*North Carolina’s now dead law did allow women to decide what type of ultrasound they would receive, so at least it wasn’t a forced rape in addition to the medical procedure and lecture.

** Funny how the same exact people who think women need a mandated waiting period to make up their flighty little minds about abortion, get outraged if you suggest that maybe people should have to wait a day or two to buy a handgun.

About the Author

Described as "intelligent but self-destructive," Foster Disbelief spent his twenties furiously attempting to waste his potential in a haze of religion and heroin. Science and atheism allowed him to escape his twin addictions and he now spends his days attempting to make the most of his three remaining brain cells.